Prostate cancer screening practice among men age 75 and older: Results from a national survey

Abstract

e16034 Background: The U.S. Preventative Services Task Force recently recommended not to screen men aged 75 and older for prostate cancer. This study evaluated the use of prostate specific antigen (PSA) screening among men age 75 and older prior to this declaration. Methods: The study cohort comprised 718 men age 75 or older without a history of prostate cancer who responded to the 2005 National Health Interview Survey, representing an estimated 4.47 million non-institutionalized men annually. Univariable and multivariable logistic regression was used to determine factors associated with PSA screening. Results: Of the 718 men, 19.2 % were age 85 or older, 42.2% reported fair or poor health, 24% had two or more significant diseases and 10.9% were dependent in at least one instrumental activity of daily living (IADL). More than half (51.6%) underwent PSA screening within the previous two years. Men who reported poor health status (42.2 vs. 55.2%, p=0.005) and men who had difficulty with at least one IADL (37.4 vs. 53.3%, p=0.010) were less likely to have a screening PSA. After adjustment for age, race, education status, and physician access, poor health status (adjusted odds (AOR): 0.70, 95% CI (CI): 0.45 to 1.10; p = 0.119), two or more significant diseases (AOR: 0.78, CI: 0.48 to 1.27; p = 0.333) and difficulty with at least one IADL (AOR: 0.71, CI: 0.42, 1.20; p = 0.202) were not associated with the use of PSA screening. Of the 104 men likely to live for five years or less because of poor health, 35.0% underwent PSA screening. Conclusions: Health status, a predictor of life expectancy, should be considered when determining which men receive PSA screening. This would reduce the use of PSA screening in men unlikely to benefit. No significant financial relationships to disclose.